Healthcare Ready Hurricane Ian Situation Report #15

Hurricane Ian Situation Report #15

This report provides an assessment of the impacts to healthcare and public health due to Hurricane Ian. Pending any major updates, our last situation report for Hurricane Ian response will be 10/20.

Note: Green text indicates new or updated content in this report compared to the previous report.

Healthcare Ready's Posture

Healthcare Ready is ENGAGED for the response to Hurricane Ian. We are tracking potential impacts to healthcare infrastructure and supply chain, sharing information via situation reports, TwitterFacebook, and LinkedIn. Our pharmacy operating status map Rx Open will be updated every other day for pharmacies and dialysis centers in Florida, Georgia, South Carolina, North Carolina, and Puerto Rico. Rx Open updates will be paused following the 10/19 update.

High-Level Situation Summary

About 14,000 customers remain without power in Florida, with most outages concentrated in Pine and Sanibel Islands in Lee County. As previously reported, healthcare operations in the state have largely been restored, though many smaller or satellite facilities (including clinics and urgent care centers) still report some damages and modified operations.

Disparate delays in restoring critical infrastructure (power, water, internet) in different areas signal a need to consider equity as part of future disaster response and recovery plans. Despite continued challenges, resources (disaster recovery centers, PODS, fuel trucks, Wi-Fi hotspots) are increasing daily and are being made available in areas where support is most needed. These resources have been brought in in many ways, including through innovative sources (via businesses and partnerships). Hurricane Ian, one of the most disastrous events to hit the state of Florida, may very well be an exemplary model for a partner-centered approach to recovery from disasters. As seen throughout this recovery process, public-private sector partnerships in disaster response are a strong tool towards disseminating critical resources, achieving sustainable healthcare infrastructure restoration, and community recovery.

Highlights

  • In Florida, there are 9 pharmacy closures reported on rxopen.org as of 2:00pm EST on 10/18.
  • As of 10/18, over 14,000 residents remain without power, with over 11,000 outages remaining in Lee County.
  • As of 10/17, parts of 10 counties still remain under boil water advisories.
  • Lee County Electric Cooperative has estimated that essential electric infrastructure may be restored as early as October 20.
  • As of 10/18 access to Fort Myers Beach from the south will be limited to essential response personnel to speed restoration of essential services and infrastructure. Starting Wednesday, 10/19, residents and their hired contractors can access the island from the south from 9 am to 5 pm.
  • Temporarily restored Sanibel Causeway is now allowing convoys to reach the island in order to restore power. Full restoration of the causeway is expected to be finished by 10/21.
  • Free telehealth services continue to be available for patients in impacted areas. See the “Healthcare Response Updates and Needs” section for more details. 
  • For the latest local updates, including detailed information on fuel, water, and other resource sites, visit the governor’s website and floridadisaster.biz/currentdisasterupdates for more information.
  • UPS, FedEx, and USPS are still experiencing service impacts, for communities on Pine and Sanibel Island which were cut off to road access.
  • Federal, state, and local agencies are urging citizens to be aware of the possibility of fraud, scams, and cybersecurity threats following Hurricane Ian.

Assessment of Healthcare and Logistics Impacts

Emergency Declarations and Measures

  • General
    • No changes or updates since 10/11.

Critical Infrastructure Impacts

  • Power
  • Fuel 
  • Water
  • Communications 
  • Transportation
    • Road Closures and Travel Updates
      • Florida
        • No major impacts to transportation are expected to affect supply chain and distribution of healthcare supplies. Local supply movement to areas like Sanibel Island may be impacted until roads are fully restored.

Access and Re-entry

  • No updates since 9/30.
  • Florida
    • Florida’s access and re-entry plans and policies are managed by local officials, working closely with Florida’s Division of Emergency Management. During a disaster, private sector companies should coordinate with the Division of Emergency Management, in addition to local health departments and local emergency managers to assess whether they are authorized to enter an impacted area, only after it has been deemed safe enough to do so.
    • Individuals who wish to enter the disaster area must have the following on hand:
      • Valid government-issued ID (driver’s license, passport)Proof of employment (employer credentials, document on company letterhead)
      • Demonstrated need to enter the area (work order, inventory list, employer authorization)
      • Note, DHS CISA’s Access Coordination Letter is not an acceptable document to enter any disaster areas in Florida.

Healthcare Response Updates and Needs

      • Healthcare Facilities
        • Healthcare infrastructure has largely stabilized as facilities are resuming normal operations. There are still ancillary facilities that remain close due to major structural damage and may impact families that depend on their services. As expected from the impacts of the hurricane, most closures are in Lee County, potentially impacting the aging, Black, and Latinx populations.
        • FACHC asks Florida’s Health Centers to report their status and resources needed using the Live Response Tool or by contacting 850-591-1832 or gianna@fachc.org.
        • The Agency for Health Care Administration for the State of Florida is collecting health facility status. All licensees providing residential or inpatient services are asked to update status via the Health Facility Reporting System.
        • As of 10/17, HCA Florida Fawcett Hospital in Port Charlotte has resumed additional operations including surgery, radiology, select in patient service, etc.
        • AdventHealth is still reporting some operational impacts from Hurricane Ian here. Most urgent care centers, primary care centers, and other specialty facilities have reopened, however patients in Central or West Florida are advised to call the location to confirm hours before traveling. Specific updates for hospitals in impacted areas are below.
          • CentraCare will remain open for free video visits for non-emergency patients. Use promo code “Ian” to access free visits on the AdventHealth app. 
        • NCH Healthcare System status updates on services and open locations are being posted online. As of 10/13, the hospital is still only open to seeing emergency patients.
          • NCH Virtual Care is accessible to anyone in the community at no cost, 24-hours per day, 7 days a week for two weeks following Ian. Use the coupon code “NCH”.
          • For patients who do not have internet access, the NHC Employee Medical Center in the Greentree Plaza is open from 7:00am-7:00pm for patients to use Wi-Fi.
        • Since 10/6, all Lee Health hospitals and emergency departments are fully operational. A full list of reopenings across all Lee Health facilities can be found here).
      • Emergency Medical Services
      • Pharmacy
        • Rx Open is activated for Georgia, Florida, South Carolina, and North Carolina. It was last updated on 10/18 at 2:00pm EDT and is showing 9 pharmacy closures across Florida and Georgia, with closures primarily in Florida.
        • Please see the table outlining pharmacy statuses per state below:
          • OptumRx provided guidance to customers for rerouting existing prescription deliveries to new addresses. 
          • Pharmacy deliveries via Express Scripts may arrive late as recovery operations continue. 
      • Dialysis
  •  

Public Health Impacts

  • Infectious illnesses
    • With people entering and/or remaining in shelters due to the hurricane, there is an increased risk of transmission of COVID-19 and other infectious diseases.
      • As of 10/16, CDC reports 9,886 total COVID-19 cases, an average of 185.43 new hospital admissions, and 53 deaths over the past seven days in Florida.
      • As of 10/17, the CDC reports 2,648 confirmed monkeypox cases in Florida (higher than reported on 10/13).
  • Chemicals/Flood Water
    • As of 10/18 no other carbon monoxide related deaths have been reported in Florida.
    • Gas and diesel can generate carbon monoxide when generators are not properly used. This can cause dizziness, headaches, and other negative health effects. Breathing can also be impacted by mold and pollutants in the air. Practice safe generator usage to decrease risk of health implications.
  • Mosquito-borne illnesses
  • Waterborne hazards
  • Mental health
    • Mental health resources for individuals and communities are available at MyFLFamilies.com/HurricaneIan. The state has compiled a list of mental health resources at https://www.floridadisaster.org/dem/recovery/disaster-mental-health-resources/.
    • The Crisis Center of Tampa Bay offers a free mental health helpline for first responders and their loved ones. The program focuses on Charlotte, Collier, DeSoto, Glades, Hendry, Hillsborough, Lee, Manatee, Pasco, Pinellas and Sarasota counties. Firefighters, police officers, emergency care providers and other first responders can reach the program by filling out a web form at lasttoask.com and can receive confidential support by calling 1-866-435-4376 (1-866-4FL-HERO).
    • Florida Blue is offering free virtual doctors’ visits and a bilingual emotional support helpline for Floridians impacted by Ian at 855-225-5032 for visits, and the helpline at 833-848-1764 for emotional support. Both lines are available 24/7.
    • The Florida Behavioral Health Association provides a list of helplines offered to Floridians in various counties, including an Aspire Health Partners helpline that residents of Orange, Osceola, Lake and Seminole counties can call at 407-875-3700, ext. 2.
    • The Veterans Crisis Line is a free, confidential resource that is available to veterans 24/7. The service is available to all veterans, even if you are not registered with the VA or enrolled in VA healthcare. You can call 800-273-8255 ext. 1, text 838255, contact the veterans crisis chat, or dial 988 ext.1
    • The Hurricane Ian disaster recovery hotline is available for mental health needs, disability services, military and veteran assistance, and other needs.
    • Individuals may call or text 211 to be connected with help for physical and mental health needs and assistance in the aftermath of Hurricane Ian.
    • The SAMSHA Disaster Distress Helpline 1-800-985-5990 is open 24/7 to provide immediate crisis counseling for people who are experiencing emotional distress. The Helpline is toll-free, multilingual, and confidential and is available to all residents in US and its territories via phone or text. Deaf or hard of hearing callers can utilize a videophone or ASL Now.
  • Other
    • Persons found and reported safe can be reported at safe.fl.gov.
    • This website is for reporting missing persons related to Hurricane Ian.
    • US government agencies have shared that routine non-criminal immigration enforcement operations will not be conducted at evacuation sites or assistance centers.
    • Disaster Unemployment Assistance (DUA) is available to Florida businesses and residents in FEMA disaster-declared counties whose employment or self-employment was lost or interrupted as a direct result of Hurricane Ian.

Supply Chain

  • Manufacturing
    • No updates as of 10/18.
    • Manufacturers in Florida have not reported any major impacts. There are no expected impacts to Georgia, South Carolina, and North Carolina supply chain.
  • Distribution
    • As of 10/18, UPS is continuing to report that most UPS facilities are operational as conditions permit. There will still be no pickups or deliveries today in zip codes listed below . Disruptions in service to Pine Island may decrease soon as a temporary bridge restoring road access to the island has been established as of 10/6.
      • 33924 – Captiva
      • 33957 – Sanibel
      • 33931 – Fort Myers
    • As of 10/18, FedEx is reporting delays and disruptions for inbound and outbound shipments in the following zip codes below. Much like UPS, the service areas affected are in barrier island counties and along the southwest coast of Florida which is where Hurricane Ian did the most damage to critical infrastructure and roadways. As temporary bridges and roadways clear, we expect the disruption to services areas to decrease.
      • 33952 – Bokeelia
      • 33924 – Captiva
      • 33957 – Sanibel
      • 33931 – Fort Myers
      • 33956 – St. James
      • 33993 – Cape Coral
    • As of 10/18, US Postal Service reports that 11 facilities remain temporarily closed until further notice. Each of the 11 facilities have an alternate location provided.

Resource Staging

  • As of 10/13, all PODs that had been distributing food, water, fuel, etc. have been stood down.
  • More than 14 million meals and 51 million bottles of water have been distributed so far.
  • 6 barges are aiding in the delivery of commodities in Lee County to Pine Island and Sanibel.
  • Areas and counties eligible for FEMA Individual Assistance include Big Cypress Indian Reservation, Brevard, Brighton Indian Reservation, Charlotte, Collier, DeSoto, Flagler, Fort Pierce Indian Reservation, Hardee, Hendry, Highlands, Hillsborough, Hollywood Indian Reservation, Immokalee Indian Reservation, Lake, Lee, Manatee, Monroe, Okeechobee, Orange, Osceola, Palm Beach, Pinellas, Polk, Putnam, Sarasota, Seminole, St. Johns, Tampa Reservation, and Volusia. Impacted residents can apply at DisasterAssistance.gov.
  • Florida’s Department of Children and Families (DCF) has created a First Responder Support Line (407-823-1657) that all first responders throughout the impacted areas can contact. This line combines current resources into a single point of contact that will connect first responders with mental health professionals.
  • The USACE has activated Operation Blue Roof to provide temporary tarp-like covering to help reduce further damage to property until permanent repairs can be made. This service is free to homeowners, and the initial sign-up period is set for 21 days, ending on October 23. Five counties are currently eligible: Lee, Charlotte, Sarasota, Collier, DeSoto.
  • The State of Florida and FEMA have opened two additional Disaster Recovery Centers (DRC) in Orange and Osceola counties.

Emergency Prescription Refills

Evacuations and Curfews

  • Evacuations:
  • Curfews:
    • Although Lee County lifted their countywide curfew, a curfew remains in place from 9pm-6am on Pine Island and Captiva.
    • As of 10/18, Osceola County’s mandatory curfew from 9pm to 6am remains in effect.
    • As of 10/12, the City of Sanibel’s mandatory curfew from 7pm-7am remains in effect.
    • From local news sources:
      • As of 10/18 access to Fort Myers Beach from the south will be limited to essential response personnel to speed restoration of essential services and infrastructure. Starting Wednesday, 10/19, residents and their hired contractors can access the island from the south from 9 am to 5 pm.  
      • The Bonita Beach area curfew, including the areas in Big Hickory Island and Little Hickory Island, is still in place from 7pm-7am.
      • A mandatory curfew is in place for all unincorporated areas of Collier County from 12am-6am. The City of Naples curfew remains in place from  10pm-6am for residential neighborhoods until further notice.

Sheltering

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